WASHINGTON (September 14, 2007)—In response to a request by the U. S. Conference of Catholic Bishops, the Congregation for the Doctrine of the Faith has reaffirmed the Catholic Church's teaching on providing nutrition and hydration to patients in a persistent "vegetative state."
The bishops presented two questions in a formal manner, known as a "dubium," to the Congregation. The reply was approved by Pope Benedict XVI.
The responses reaffirm the church position that patients in a "vegetative state" are living human beings with inherent dignity and deserve the same basic care as other patients. This basic care would include nutrition and hydration, even when provided through artificial assistance.
"The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life," according to the Congregation's response. "It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented."
The bishops also asked for clarification as to whether nutrition and hydration could be removed if physicians determined that the patient would never recover consciousness. The Congregation affirmed that the patient must receive "ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means" regardless of the prognosis of recovery of consciousness.
A Vatican commentary noted some possible exceptions.
"When stating that the administration of food and water is morally obligatory in principle, the Congregation for the Doctrine of the Faith does not exclude the possibility that, in very remote places or in situations of extreme poverty, the artificial provision of food and water may be physically impossible," it said.
"Nor is the possibility excluded that, due to emerging complications, a patient may be unable to assimilate food and liquids, so that their provision becomes altogether useless. Finally, the possibility is not absolutely excluded that, in some rare cases, artificial nourishment and hydration may be excessively burdensome for the patient or may cause significant physical discomfort, for example resulting from complications in the use of the means employed."
"These exceptional cases, however, take nothing away from the general ethical criterion, according to which the provision of water and food, even by artificial means, always represents a natural means for preserving life, and is not a therapeutic treatment. Its use should therefore be considered ordinary and proportionate, even when the "vegetative state" is prolonged," it added.
The bishops asked the Holy See for clarification of the Church's teaching after Pope John Paul II's address on March 20, 2004, to an international congress sponsored by the Pontifical Academy for Life and the World Federation of Catholic Medical Associations.
"We are grateful that the Congregation for the Doctrine of the Faith responded to our request with such a thorough investigation and explanation," Bishop William E. Lori of Bridgeport, Connecticut, chair of the U.S. bishops' Committee for Doctrine, said in introducing the Response. "We hope the Church's documents on this issue will provide help and guidance to pastors, ethicists, doctors, nurses and families involved in the care of those diagnosed as being in a persistent 'vegetative state.'"
The responses from the Congregation for the Doctrine of the Faith (CDF) (www.usccb.org/comm/hydrationletter.doc), a CDF commentary (www.usccb.org/comm/hydrationcommentary.doc), approved by Cardinal William Levada and bishop members of the Congregation for the Doctrine of the Faith, and a Q&A from the USCCB Committee on Doctrine and Committee on Pro-Life Activities (www.usccb.org/comm/hydrationq&a.doc ) can be found on the Web.